Please follow up with our physician in Canada for up to 12 months after the surgery

What is Obesity?

According to the World Health Organisation (WHO) overweight and obesity are defined as abnormal or excessive fat accumulation that presents a risk to health. A crude population measure of obesity is the body mass index (BMI), a person’s weight (in kilograms) divided by the square of his or her height (in metres). A person with a BMI of 30 or more is generally considered obese. A person with a BMI equal to or more than 25 is considered overweight. The fundamental cause of obesity and overweight is an energy imbalance between calories consumed and calories expended. Globally, there has been an increased intake of energy-dense foods that are high in fat; and an increase in physical inactivity due to the increasingly sedentary nature of many forms of work, changing modes of transportation, and increasing urbanization. Changes in dietary and physical activity patterns are often the result of environmental and societal changes associated with development and lack of supportive policies in sectors such as health, agriculture, transport, urban planning, environment, food processing, distribution, marketing, and education.

BMI = Weight (kg) / Length (meters)²

<18.5 Low Weight
18.5-25 Normal Weight
25-30 Overweight
30-40 Obese
>40 MorbidObese

 

Why has the rate of obesity increased in recent years?
Within the last half century, our food has drastically changed. Things we eat now are not the same as they once were. Much more high-calorie and refined (processed) carbohydrate-containing foods began to be consumed. Much more high-calorie and refined (processed) carbs containing foods have began to be consumed. In fact refined sugar can be described as simple sugars that are half-digested. These foods are more durable than other complex sugars, because their use is much cheaper. In addition, we made a quick transition to immobile life. Unfortunately, these reasons cost us obesity and many diseases associated with obesity.

What are common health consequences of overweight and obesity?
Being overweight or obese can have a serious impact on health. Carrying extra fat leads to serious health consequences such as cardiovascular disease (mainly heart disease and stroke), type 2 diabetes, musculoskeletal disorders like osteoarthritis, and some cancers (endometrial, breast and colon). These conditions cause premature death and substantial disability. The majority of obesity-related diseases disappear when obesity is treated, ie when patients reach normal weight.

What are the different types of weight-loss surgery?

Sleeve Gastrectomy
It is now the most commonly performed bariatric procedure worldwide. The procedure is typically performed laparoscopically, which involves inserting small instruments through multiple small incisions in the upper abdomen. During sleeve gastrectomy, about 80 percent of the stomach is removed, leaving a tube-shaped stomach about the size and shape of a banana. Sleeve gastrectomy is typically done only after you’ve tried to lose weight by improving your diet and exercise habits. Limiting the size of your stomach restricts the amount of food you are able to consume.

Roux-en Y Gastric Bypass, RNY gastric Bypass
The gastric bypass is considered the most reliable operation for long-lasting weight loss because of its multiple mechanisms. In addition to creating a smaller stomach pouch (which results in smaller meals), the procedure also results in less digestion and less absorption of calories. The gastric bypass reduces the stomach from the size of a football to the size of a golf ball and bypasses several feet of small intestine

Mini Gastric Bypass, One Anastomosis Gastric Bypass
The mini-gastric bypass is quicker, technically easier and carries a lower complication rate compared to traditional gastric bypass surgery. The mini-gastric bypass procedure is restrictive and malabsorptive. This means that the procedure reduces the size of your stomach, restricting the amount you can eat. The procedure also reduces absorption of food by bypassing up to 6 feet of intestines.

Frequently Asked Questions

Which weight loss procedure is the best?
This decision is best made between patient and surgeon. Surgeon will discuss the operations and the risks and benefits of each procedure and will help patient make the best decision after a careful evaluation.

Why obesity surgery is more effective and successful than other treatments?
Because obesity is a vicious circle. As the patient gains weight, it becomes difficult to move, and the patient becomes inactive. The more patient is inactive, the more weight patient gains. Obesity surgery breaks this vicious circle and makes the patient more mobile by feeding with less food. Obesity surgery provides an advantage that cannot be achieved with other treatments in decreasing appetite and controlling blood sugar.

How long does it take to be discharged from the hospital and to get to work?
If everything goes as expected, patient will be discharged on the third day after surgery and can start working after a period of 4-5 days at home. For patients coming from other cities and abroad, we recommend them to stay in Istanbul for 3-4 more days after discharged. 3-4 hours after surgery patient can start walking. Since the operation is performed with standard laparoscopic (closed operation) method, postoperative pain is almost negligible.

Is there any scars after the surgery?Since the operation is performed with very small incisions by laparoscopic method, using camera and special hand tools, the scar will be very small and vague after operation.

Does everyone get loose skin after surgery?
Any individual who is losing weight is at risk for loose skin. Although this is somewhat depend on the patient’s skin structure, protein-rich nutrition and regular exercise are measures to reduce loose skin. Age and initial weight of the patient are also important. Loose skin with a body mass index of less than 50 kg/m² is almost never seen in young patients. In spite of these precautions, skin stretching operations can be performed if the loose occurs on the abdominal skin, chest, arms or legs. The appropriate time for skin stretching operation is at least one year after surgery. Because, ideal body weight should be expected to reach.

Can I get pregnant after surgery?
You should wait at least 1 year before getting pregnant. Otherwise, the goal will not be realized and weight loss will be prevented. In addition, the failure to deliver sufficient liquid and nutrients to the fetus and various deficiencies in the child will increase. It is recommended that our patients with the idea of getting pregnant should receive contraceptive support in the preoperative period.

What are the risks of weight loss surgery?
Obesity surgery also involves various risks like any surgical operations. The risk of complications accepted in the first obesity operations is around 2%. In other words, 98% of the patients are discharged without any problems and continue their lives. Our specialist physician has performed more than 1,000 obesity and diabetes operations and the complication rate is 0.3%. Leakage and bleeding are the most known and feared risks. In order to prevent leakage, it is very important to develop surgical technique and to apply standard methods by experienced surgeons. Thanks to the special sewing technique used by our specialist doctors, the probability of leakage or bleeding is very low. Leakage tests performed during the surgery and intervention of the leakages detected at that time also reduce the probability of postoperative leakage. Obese individuals are at high risk of deep vein thrombosis after surgery. In order to prevent this, wearing compression stockings, blood thinner needles (low molecular weight heparin) and early walking after surgery is vital. All precautions are taken for deep vein thrombosis in our clinic.

What should be considered after surgery?
Before surgery, it is necessary to talk to a dietician and to get detailed information about the postoperative diet. Patient will be given a diet plan that can be easily followed. It is also recommended that the patient should avoid doing heavy exercise during the first month. Exercises such as walking, swimming, etc will be more appropriate for the first month. All kinds of sporting activities can be done 1 month after the operation including pilates, cycling, fitness and weight training. Active lifestyle is indispensable for healthy life. In addition, regular control in the postoperative period is very important. Vitamin and mineral levels should be checked every 3 months in the first year, every 6 months in the second year and then once a year.

Do I regain weight after having obesity surgery?

After obesity operations, at least 85-90% of the patients start a new life and continue their life without regaining weight. However, approximately 10 to 15% of the patients complain about restoring their weight or not being able to lose enough weight. There may be several reasons.

  • A very high initial body mass index is a reason. For example, if a patient weighing 200 kg before surgery and loses 80 kg it means that patient is still obese and cannot reach normal weight; but healthier than before.
  • After obesity surgery, the majority of patients cannot believe how small portions they are saturated and how long they do not feel hunger. Therefore, they try to eat food after saturation, which pushes the shrinking stomach volume to grow.
  • Excessive consumption of liquid, high-calorie foods such as alcohol, ice cream or chocolate may result in weight gain for some patients.
  • Sometimes tube gastric surgery develops a faint stenosis in the middle of the stomach. The patient may or may not feel this stenosis with mild reflux complaints. However, the stomach remaining in the upper part of this stenosis may widen over time and cause weight gain (even if the patient obeys all the rules).
  • The enlargement of the small stomach left during gastric bypass over time or the connection between the stomach and the intestine may also result in weight regain.

A detailed examination is required for patients who regain weight after obesity surgery. Firstly, it should be treated if there is a psychiatric or hormonal problem. After the reasons are determined for regaining weight revision operations may be considered. Revision surgery is performed successfully in experienced centers. Our specialist doctors performed more than 200 revision operations due to weight regain after tube gastric surgery performed in other centers with a complication rate of less than 1%.